Healthcare Provider Details

I. General information

NPI: 1336210384
Provider Name (Legal Business Name): TRIPLE R BEHAVIORAL HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 08/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 W APACHE TRL #10
APACHE JUNCTION AZ
85220-3958
US

IV. Provider business mailing address

40 E MITCHELL DR SUITE 100
PHOENIX AZ
85012-2330
US

V. Phone/Fax

Practice location:
  • Phone: 480-288-0850
  • Fax: 480-288-1332
Mailing address:
  • Phone: 602-995-7474
  • Fax: 602-973-2993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberBH3265
License Number StateAZ

VIII. Authorized Official

Name: MR. WAYNE E. HOCHSTRASSER
Title or Position: PRESIDENT, CEO
Credential:
Phone: 602-995-7474